This invention is a device and the methodology of its use for removing a section of tissue from a patient. More specifically, the device and method cut and secure tissue while preserving a tissue margin for pathological examination.
In both traditional and minimally invasive operations, a section of abnormal tissue, such as cancerous or diseased tissue, as well as cystic adenomatoid malformations, vascular lesions, sequestrations, infected tissue, cavitary lesions, and the like, is removed from a region of otherwise healthy tissue. Many surgeons use a surgical apparatus that both resects the abnormal tissue from the healthy tissue and seals the edges of both surfaces of cut tissue. Sealing the edges of the healthy tissue promotes healing and permits it to function normally. Sealing the edge of the abnormal tissue prevents contamination of the wound during operation and helps maintain the integrity of the specimen to facilitate subsequent dissection.
Many surgeons position the line of resection a short distance from the abnormal tissue to ensure the abnormal tissue is completely removed from the patient. After the operation, a surgical pathologist examines the resection specimen grossly and histologically to determine the nature of the abnormality, its extent, and the distance between the resection line and the closest component of the abnormal tissue. The distance between the resection line and the abnormal tissue provides information for the medical staff to determine if subsequent treatment, such as additional surgery or radiation, is necessary. For example, if the abnormal tissue abuts the resection line, surgery to remove additional tissue may be required. Conversely, if the line of resection is free of abnormal tissue and is a sufficient distance (for example, several millimeters) from it, then no additional treatment may be dictated.
Prior surgical devices deploy rows of fasteners on tissue along a line of division created by the cut of a knife deployed from the same device. This action divides the organ into a specimen side with abnormal tissue and a patient side of tissue that is assumed to be healthy. These rows of fasteners occupy and damage the tissue along the resection line, rendering the margin between healthy and abnormal tissue unavailable to analysis—the tissue with the embedded fasteners (the actual resection margin) is removed and discarded, and the adjacent tissue is then designated the true margin and is removed and examined histologically. This underestimates the distance of the abnormal tissue from the surgical margin. In some situations, the abnormal tissue is very close to the fastened tissue margin because of anatomical constraints or functioning organ tissue cannot be sacrificed as in an infant. Accordingly, a resection margin may be incorrectly identified as being extremely close or positive for abnormal tissue. Unfortunately, any additional surgery or radiation involves loss of more functioning organ tissue and may be accompanied by a serious reduction of organ function, higher risk of postoperative complications and sometimes emotional distress, especially if the patient is elderly or an infant.
Therefore, it is essential to have a surgical apparatus that preserves tissue along the resection line of a tissue specimen, at the true resection margin, that is appropriate for histological examination. It is also important to have a surgical apparatus that reduces the possibility of requiring unnecessary and potentially harmful surgery to remove additional tissue from a patient.